Should you tackle acne or hyperpigmentation first? A derm weighs in

October 12, 2019 at 02:00AM by CWC

It’s estimated that every pimple has a 6 percent chance of turning into a permanent scar, according to New York-based dermatologist Joshua Zeichner, MD. That’s not super high—what’s more common is actually hyperpigmentation. “Think of these dark spots like stains in the skin from where there used to be inflammation,” he says. Hyperpigmentation and acne can go hand in hand, but which one should you focus your skin-care efforts on first?

“Unfortunately, the dark spots tend to stick around for much longer than the original pimple and can take several months to fade,” says Dr. Zeichner. While there are some treatments that can tackle acne and hyperpigmentation at the same time, like retinoids, he says that out of the two problems, dealing with the acne should take priority. Think of it when a guy says he’s just got too much going on, like his volleyball league, to commit to you, but he’s still down to come over at 1 a.m. Acne is the volleyball league, you’re the hyperpigmentation. This is not a perfect analogy, but it’s the one the internet generally deserves. “Unless you treat the acne, you will be fighting a vicious cycle of new pimples leaving new dark spots,” says Dr. Zeichner. “Generally speaking I tackle the acne first. Once that is under control, then I address the hyperpigmentation.” Some ingredients that can be used to treat dark spots, like rose hip oil, will not help with acne. So leave those until you have your breakouts under control.

To help curb breakouts, he recommends products with benzoyl peroxide or salicylic acid. (The latter can actually help with hyperpigmentation as well “because it enhances exfoliation of pigment and cells on the surface of the skin.”) The benzoyl peroxide zaps acne-causing bacteria. Also, look for products with vitamin C. “Vitamin C is a potent antioxidant that neutralizes free radical damage and blocks abnormal pigment production,” says Dr. Zeichner. “The antioxidant effect may also be a benefit if you have acne. Oxidation of sebum in people with acne leads to free radical damage, and sebum on the skin is a driving factor in acne.”

You could also try retinol. “Retinol is a vitamin A derivative that is commonly used for aging skin because it stimulates collagen production,” says Dr. Zeichner. Because it helps speed up skin cell turnover, it can also help brighten dark spots. “It exerts anti-inflammatory benefits so it may be useful in acne prone skin,” he adds.

Even though acne should be your first priority, Dr. Zeichner says that you shouldn’t wait too long to address hyperpigmentation and dark spots.” If you have acne and are developing marks on the skin, make sure to visit a board-certified dermatologist for evaluation and treatment,” he says. “Acne scars are preventable if addressed early. If you wait too long, only lasers or other in office procedures will be able to improve the texture of the skin.”